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Monday, November, 23, 2009
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I is for Insulin

David Mendosa
David Mendosa
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Medical Journalist Living with Diabetes and Author of Fitness and Photography for Fun, www.mendosa.com/fitnessblog

After earning a B.A. with honors from the University of California,...

David Mendosa

Sunday, June 03, 2007
View All of David Mendosa's Posts
Like hypos last week, insulin is in the news. Considering that nothing is better at causing hypos than insulin is, they are connected in more ways than one.The big question with insulin in the news now is how come we have generic sulfonylureas and metformin, but no generic insulin? After all, insu...
  1. Insulin Pricing
    Don Lloyd
    Monday, June 04, 2007 at 06:27 AM

    David,


    While the lack of generic versions is an obvious answer to the high and rising pricing of insulin, it seems to me that the problem is much more complex.


    Consider the pricing of test strips. Three hundred Lifestyle strips shows a retail price of $325, up from $240 not too many years ago. It would be hard to argue that the test strip market is not highly competitive, and there is not even a requirement for a prescription for purchase. While test strips are not interchangeable between meters, the monetary cost to change meters is minimal, even if they were not available for free. (learning curve costs might be more significant).

     

    It is more likely that the high retail prices are the result of the fact that the insurance companies dominate the demand and the dollar sales yield comes almost completely from the discounted and rebated insurance company payments. Raising the retail price doesn't reduce company revenue to any great extent and may even increase it to the extent that the retail prices may set a reference point for discounts.

     

    It seems likely that, in many cases, retail drug prices are above the prices that a monopoly producer would maximize his profit by charging on a free market if it weren't for the third party payment environment of the insurance companies.

     

    Regards, Don

    Reply
    re: Insulin Pricing
    David Mendosa
    Monday, June 04, 2007 at 10:50 AM
    Don,

    I don't doubt that the insulin market in the U.S. is approaching monopolistic pricing. But that's not true with test strips. Yes, the LifeScan test strips are expensive. According to a review this month in Diabetes Health magazine their list price is $0.94 each. But other test strips list for as little as $0.35 each.
    Reply
  2. Not pushing for generic insulin
    Walter
    Tuesday, June 05, 2007 at 06:41 PM
    God knows what would be in it, how comparable it would be in quality and do you trust the stuff you have to inject? My generic blood pressure medicine is not as good as the brand name was, Dr. Bernstein claims that the generic metformin is not good, and if it is really cheaper to purchase less active ingredient and what is generic insulin going to be affecting in the long term? I don't want to inject a generic. Period. The cost will always be high with our health care system no matter what. There are people who cannot take your oral agents suggested and then what? I gained a tremendous amount of weight on insulin. Over 36 pounds. My doctors never admit it. They think I am cheating. Just in the past week I lost ten pounds switching from NPH to Novolog only. They are stubborn, untrustworthy, and greedy, the whole lot of them, the docs, the drug companies and the entire system. They make money off diabetes. The cure will never come.
    Reply
  3. I is for Insulin
    clk
    Friday, June 08, 2007 at 08:38 PM

    "But for those of us with type 2 diabetes, it could be even better news to use metformin or Byetta. Neither of these medications lead to hypos. And metformin is weight neutral, while Byetta can lead to substantial weight loss."


    David, please remember that just because Byetta and metformin work for you does not mean that it works for all type 2's. I am one of them, byetta worked for only 2 1/2 hours after shot and then my bG would start elevating rapidly with no weight loss and when I was given metformin(the first prescribed drug) my bG continued to rise and it seemed like metformin did nothing. I still take metformin but it still does not seem to do anything. I currently take Januvia and it seemed to help some but it was only when I was prescribed Lantus that my bG started to go down. FYI I have never had a hypo and I have taken Lantus for 6 months. My A1c is down from 7.8 to 6.6.


    cindy

    Reply
  4. Insulin and hypos
    vicki
    Monday, June 11, 2007 at 11:43 PM

    If diabetics were taught how to use insulin properly there would be a lot less hypos.


    First of all, mixed insulins are OUT. One shot is nice but it rarely works to maximal benefit.


    Diabetics on insulin need to take a basal (long acting) insulin for background (between meal) coverage and then a fast-acting insulin such as Novolog or Humalog MATCHED TO CARBS EATEN AT THE UPCOMING MEAL like pumpers do, for best effect. For this, they need to know their carb to insulin ratio. There are mighty few doctors who understand this and even fewer insulin using diabetics who do. It takes some work and experimentation. But the end result is excellent glucose control with minimal hypos.

    Reply
  5. Generic Insulin
    Anonymous
    Saturday, November 14, 2009 at 10:48 PM

    My husband is a type II diabetic and must take insulin because of other health problems that affected his kidneys.  Oral diabetic medication is too hard on his kidneys.  I think it is almost criminal how much pharmaceutical companies and pharmacies charge for insulin.  The costs in Canada are so much lower for the same product.  People should write to their congressmen and congresswoman as well as Senators urging passage of the bill to allow for development and marketing of generic insulin.  It's time citizens were heard regarding the high cost of health care in this country.  Special interest groups have too long influenced our elected officials to our detriment.

    Reply
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